I am a 91-year-old father and grandfather recently widowed. I cared for my wife and now live alone. I was recently diagnosed with Parkinson’s disease in addition to my other chronic illnesses. This is a major life transition for me. One of my worries is how my daughters will handle future changes in my life situation. They never got along and there was always sibling rivalry. How can I bring peace to their relationship, when caring for me may bring on more stress? — J.D., Oakland
Caregiving for parents can bring forth an eruption from the past. There may have been pain and damage in your daughters’ relationships during their early years. It could have been emotional, physical or both, and never healed. Since we are all living longer, often with chronic illness, adult children may care for their parents a decade or more. There is no roadmap for this journey and it’s normal for all involved to feel a range of emotions.
Research findings among clinicians and developmental psychologists show that the sibling bond is complicated, fluid and influenced by many factors. Parental treatment, life events, ethnic and generational patterns, people and experiences outside the family all contribute to the success or failure of a particular sibling connection. Gender and genetics are other contributors.
No matter what kind of relationship your daughters have, they, too, are grieving. They recently lost their mom and they are worried about you. It’s not clear from your question if both daughters want to be involved in your care. Having a family meeting with your daughters or with the help of a third neutral party, such as a social worker or a care manager, can help spell out who will do what, the compensation if any that may happen and what support will be available for care. Having a social worker during the meeting will prevent the family unit from slipping into old roles that may no longer work in the current situation.
Although providing care can be complicated, there are several things you can do to lessen the conflict between your daughters. For example, it would be helpful to have an advanced health care directive and a conversation with your daughters about your wishes, and to put in writing how you want to live during the last chapter of your life. This will bring clarity and a more healthy decision-making process for your daughters. Also, siblings may have different ideas about your needs, but with a professional assessment from a social worker or a geriatric care manager, everyone can be abreast of emerging care issues and keep channels of communication open.
Finances and inheritance can adjust for past inequities that your daughters may have felt growing up. Although your daughters may have unequal needs, such as one being well off with a good job, while the other daughter is struggling, you need to talk with them about the financial distribution to avoid future conflicts, so they feel equal love from you.
Ask for what’s realistic, consider your daughters’ life situations, their families, jobs, and their own health concerns. Remember that even the healthiest families can get into the cycle of guilt and anger. Once again, getting the help of an objective professional may be very useful. It will help distribute responsibilities more equitably. Even if one of your daughters lives far away from you, she can still help out: She can help pay bills online, make phone calls on your behalf, order groceries and be in charge of ordering medications in a timely manner.
End-of-life care is something we don’t like to think about or discuss. Your daughters may be uncomfortable with this subject as well. It’s important for you to initiate this talk and help them understand extreme measures that can happen in a hospital setting, unless you have specific instructions outlined about your wishes in a Health Care Directive or a Physician Order for Life-Sustaining Treatment. Assigning a health care proxy can prevent unnecessary altercation between your daughters. Nothing can sever a relationship between your children more than having different ideas about how to proceed with each step of your medical care.
I encourage you to get support for your losses and grief. Seek out your friends and professionals who specialize in bereavement. Joining a support group from the Parkinson’s Association will introduce you to others who are going through a similar journey and help you feel less isolated.
Your thoughtfulness and love toward your daughters is bound to bring about healing in their relationship. Encourage them to release the pain, make peace with the past, forgive, and move on with their lives.